Front of hip pain in endurance athletes: causes and fixes

This is session number 82 of the Performance Place Sports Care Podcast. What's your first memory in life? Welcome to the Performance Place Sports Care Podcast, where you can learn about sports injury theory, rehab, diagnosis, and how to understand the doctor lingo you didn't understand at your appointment. And now, your host, Dr. Sebastian Gonzales. Hey, everyone. Welcome back. This is Dr. Sebastian Gonzales, and I'm really, really glad to have you for the next hour or so. So, we're going to have a great guest today. He's actually a guy I've known for a very long time. It's Dr. Tim, or sorry, Dr. Tom Fletcher. Sorry, I know Tim as well.

But he's in Utah. But first, what's your first childhood memory? So, I can tell you that probably for me, actually, we had a house. Everyone has a house. There was a house that had this planter that ran down the hallway from, there was a dining room separated from the hallway with, like, this planter. Which didn't have a bottom on it. It was just kind of like, we had this, it had foam in it. So, like, you kind of stuck in these, like, crappy, fake plants so we didn't really water them or not. But it was kind of like a box to hold the foam held by pillars. So, you can walk underneath it. You can crawl underneath it. It was probably about, I'm afraid, it was probably about, like, two feet high or something like that.

So, actually, the first thing I remember was actually, my mom used to tell me I used to run underneath that thing all the time, going from the dining room down the hallway. And then I remember hitting it one day. And that's the first thing I remember. So, I think it's true that you remember significant incidences, trauma, and other things like that. A little bit better than you do your normal every day. So, yeah, I remember hitting my head. I think that's the first thing. Apparently, I didn't remember the $50 scar or Band-Aid that I got. That was a whole other story for another time. Now, Dr. Fletcher, Dr. Tom, Tim, I don't want to keep saying Tim.

Tim, you're on my mind. So, Dr. Tom Fletcher, he works in Utah. And it's in Murray, Utah. And he's someone that I met at an active release treatment team back in the day. I think it was in Oceanside. We used to do these tents where we would work on people with active release soft tissue work. And a bunch of providers came in. And I was the one kind of running the administrative part of it. So, about like 10 providers would show up. And Tom was, I mean, he's, I don't know if he practices more or he does more mileage in the week. But he's a very seasoned triathlete. So, he is very prevalent out there in the triathlete community.

And his, he gets free airfare. So, he pretty much flies all these races and just does the races. So, he was there. And I met him there. And we kind of hit it off in the same fantasy football league for a while. And all of a sudden, we realized he didn't actually check his team. So, we booted him out there too. But either way, Tom's a cool guy. So, I think we'll have some fun stuff to share. So, we're going to try to focus on hip flexors. Hip flexor pain, psoas major, psoas minor, rectus somoris. Muscular injuries that you typically find with triathlete or endurance populations. So, if you're a runner, marathoner, triathlete, and you're having some hip flexor tightness, this might give you some information about what you could do about it.

Or what are some typical things that's created? So, I will have all of the links of everything we speak about that I reference in the show notes. You can find it p2sportscare.com slash podcast slash pound, the episode number, which is going to be 82 in this case, I believe. And you can find Dr. Fletcher at wasatchhealthcare or healthsolutions.com. Sorry, wasatchhs.com. That is a mountain range out in Utah. Apparently, they have it in Utah dialect. I can't say it. That's w-a-s-a-t-c-h-h-s.com. Anyways, before we actually continue on to the interview, let me remind everybody that, number one, you need to go onto iTunes and review this if you could for me.

I would be very thankful. And can you please do it? Take a screenshot. Email to info at p2sportscare.com. And you're going to be put in a monthly drawing to get a badass soft t-shirt, the one that I wear. And regardless whether I continue to work in this profession or not, these shirts would be with me for a very long time. I believe in the, I think it's the Oprah model, where you just throw away a bunch of shit you don't use, including the t-shirts, which you don't use that much. So I throw a lot of stuff away. I would keep these. Even though they're all the same, you'd remember me as the guy wearing the blue t-shirt all the time.

Now, if you are a healthcare provider and you like what you're hearing here and you wish your patients understood what we were talking about, we try to break this down in a very simple way. So please share with them. You can obviously share it really quick through your iTunes thing, or you can actually just go on. And if you buy a poster, which is the posters I used to scratch my own back, I put them on the wall in my office. Dr. Tom has some as well. I think he might have received them by now. We'll talk about that. But I think they're very useful to educate patients about the other types of conditions that you may treat in your office.

So let's get that internal marketing bumped up. You can use these as well, and I will be having an ongoing list of how to categorize, or we're going to categorize them. So if you ever have a low back pain patient and you wish they understood the McGill basics or wish they knew how to strength train or Olympic lift with back pain, these are all topics that we've covered. So there's no reason for you to have to text them or email them all the time. Just give them access to the list. That's why I make it. Now, one thing I forgot to mention was that if you're looking for examples of some of the things that I like to do in the office, in regards to rehab treatments and so on, I put a ton of them on YouTube.

A ton. A ton. These podcasts, I'm not going to say they're easy to make because there's a little bit of editing, and I've got to find good people to interview. But the YouTube videos, they take some time. Take some time. And actually, I'm trying to put them out on Instagram this year, too. That's even harder to put good quality plus subtitled onto a platform like Instagram. So anyways, YouTube is a little bit more comprehensive. So go on to the show notes. You'll see a link to the YouTube page. Subscribe to that. We're doing a video. I'm doing a video every single day this year. 365 days of my crap that I think is useful, so it's not crap anyways.

So anyways, check that out. I think you'll really enjoy it. About 10,000 other people have liked it so far. Without any further ado, it's Tom Fletcher. Dr. Tom Fletcher. Here we go. Okay, everybody. Here's the interview with Tom Fletcher. What's up? Hey, Sebby. What's up? Nothing much. So I want to know, do you actually, do you have like a chest freezer of meat like Jake does? Out here in Utah, yeah, everybody shoots stuff and eats it, right? We're in the wild frontier out here, yeah. Wait, do you actually have, do you have patients that come in and like just give you like, here's like a whole half of an elk?

As a payment? Yeah. I thought it was just a bartering pelt system out there. It's a fair man's trade, right? Yeah. Yeah, right? I mean, that's so much better than Bitcoin or that cryptocurrency stuff. I would take half an elk any day. Yeah, you can live off that stuff. In your guy's case, you can't live off sand and smog, you know? No, you can't. Well, the smog, though, to be fair, it gets pushed about 40 miles inland, or you can see it about 10 miles off the coast. Oh, okay. So, it's not really where we're at. It's just elsewhere. We're in a nice spot. What are you talking about? You come out and do all these triathlons out here in the smog.

Yeah, you know what? That was a good point. When I've been out there doing races, I was just thinking about that. There's a little bit of fog in the morning, but after it lifts, I don't ever remember any smoggy fog, so that's a good point. Yeah. I always wonder why the Ironman Championship was over in Kona, where they have that volcano fog. That sounds like the worst thing in the world. I don't know if I've ever thought. I just enjoy going to Hawaii every other year, so I don't know. Do you say Hawaii or Hawaii? It's just bro and bra over there. Hey, bra. Okay, well, so I kind of already did an intro on you before we started this, so I told people a little bit about you, but why don't you tell people about you and why you are the dude that should be speaking about endurance sports and hip problems.

Oh, man. Endurance sports and hip problems. I've been locked in. So I went to my graduate school in the Bay Area, Northern California. I had kind of a weightlifting and a little bit of a powerlifting background, and when I moved up there, I was always interested in bikes and having a bicycle, and I bought my first bicycle up there. And the rest is history. I don't spend much time in a gym anymore. I do some band work and TRX work and some of that stuff on my own and some mobility stuff and some balls and stuff. But I am a very non-Olympic lifting guy now, and good days for me are spent running up and down hills or even better, biking up and down a hill.

And because that's kind of my groove, we tend to kind of go towards what we like to do. So I see a lot of bikers and runners in my clinic. Every biker, especially a triathlon biker or an aero biker, gets low back problems, hip problems, quad problem, maybe all of the above all at the same time. But we see a lot of that. So we have, I don't know, we get into it and we get, I know a lot about it. I'm into it. We diagnose for that stuff a lot. We have some therapeutic exercises to help them get better for that and long-term success with things like that. So anyway, so I guess because I'm into that, I understand it better.

Yeah. Is there any industry or sports-specific lingo that you think is just ridiculous? Sports-specific lingo? Yeah. Well, you already said, you just said aero. Probably half the people that don't do endurance sports are like, what the hell is aero? I was just going to say, it'll start coming out here if we keep talking. Yeah. Maybe I should save that question for later. Wait, so then, I know that, I forget who said it. I think it was one of the friends that you introduced me to. They said that Tom has big muscles for no actual strength. It's just endurance muscles. Every once in a while, people say, yeah, Tom, you got the pretty muscles.

There might be a shred of powerlifting muscles left in me, but that's not me anymore. So, do you think people can convert? Can they convert fibers? Or is it just like you just have to work harder as not being one born with those slow endurance fibers? Oh, no, absolutely not. I think you can convert fibers, absolutely. Okay. People tell me all the time, like, oh, I get these leg cramps or calf cramps if they run three miles. And it just takes time. You convert those fibers over from, again, ballistic movements, like pushing a sled or a leg press. You convert them over into, you know, endurance fibers.

So then with all your endurance people, then why do you think that, I mean, you said you mentioned cyclists especially have low back, hip, quad. What's the deal? Like, why are they getting that? Like, it seems like if it's so common, it should be able to be addressed, right? I think that's a good point. I think a lot of us, a lot of us, some of it is the blatant obvious. I think a lot of us, we go from, you know, we go from working out hard in the morning, whatever that is, whatever workout that is, to sitting on our ass for eight hours a day, maybe 12 hours a day. So we go from a lot, a lot of motion to a little motion within an hour.

So how do you, how would you stop that? What's Dr. Fletcher's life hacks on this? Boy, that's a deep one. You know, in the words of Starrett, like, he talks about doing, what does he say, doing 20 deep squats every day. You probably read that. No, I've actually never read his book. It's pretty, he's got a book called Desk Bound. That's pretty good. It's got a ton of statistics. And you know about the supple leopard. Uh-huh. It's actually, it's got some, it's very, it's very pro CrossFit. It's very lacrosse ball, foam roller, mash and smash. Uh-huh. But I think you'd get some, yeah, well, you'd get a ton out of it.

Okay. Well, so he says do 20 deep squats a day, or? He, he talks about 20 slow control to like a Tabata, like a deep squat to like ass to grass type thing a day. Um, I think you and I listened to another, another online thing where they talk about, uh, having a walking meeting rather than having a boardroom meeting where you're sitting down on a coffee pot. Uh-huh. Like having a walking meeting or having, uh, forcing like a, you know, like a 20 minute walk in there, like a brain, either brain detox or like a brain expansion or like just a free, or free 20 minutes just to think, you know? Yeah.

I was actually, I was thinking about the, uh, I suggested to a guy a walking break, um, or walking, walking meeting. And he said that that's not gonna work. I'm like, oh, how come? And he's like, well, the receptionist, she doesn't like walking. I'm like, well, it's even more reason to put it in place. Yeah. Pretty sure if she's your receptionist, you're paying her, dude. Yeah. Oh, that's a good point. I should have told, I should have said it. Um, okay. So once you break down some hip pathologies for me then, uh, so if I have pain on the front side of the hip, what are the possible diagnosis that you're thinking with, uh, an endurance person?

Yeah. Now, um, now I, I, you know, we've had a couple of these just this week. A lot of times, a lot of times, you know, people came with that anterior front, front of the hip pain, and we think it's a hip flexor. I mean, the common word is a hip flexor, not so as, right? I find, um, a lot of times it may not even be the hip flexor or, well, a lot of times it's a, it's an upper, it's a, it's a proximal, proximal quad. It's not always, I guess the upper quad is a hip flexor, but sometimes it's a quad problem. It's like a rectus femoris, TFL, something like that, iliacus. It's not always a psoas, do you know what I mean?

A lot of people know the psoas, they're probably just drawn to the idea, right? Yeah, and I think, I think hip flexor, I think the term is maybe even becoming more popular. Yeah, probably. I mean, I know there's more than one hip flexor, obviously. Yeah. But yeah, I mean, I don't know. I tend to think there's less psoas problems than there actually is now. I don't know if you, I don't know how frequently you actually go down the route of the actual psoas major being the thing. Yeah, I guess it depends. Anytime, if there's a, if there's a hip pain, and there's a history of back pain, then, you know, connecting the dots, a lot of times that lower back pain, kind of that lower back pain, it's about an inch and a half above our butt crack.

It's usually on both sides of our back, kind of like a low, low, low, low back, almost like an upper butt pain. If they have that, and especially sitting on a bicycle for two hours in the morning and then sitting in a chair for eight hours a day, if there's stiffness or back pain like that type stuff, I feel like it can be in the psoas or the hip flexor. But I think, to your point, if it's just in the front of the hip, sometimes I think you're right. Sometimes I think it's more of an upper quad, if that makes sense, or a proximal, meaning upper. It's more of a quad problem than it is a, without getting too anatomical.

It's hard not to throw out anatomical terms and expect everyone to understand, right? I know. It's funny. Actually, I have a friend who he listens in, and he's like, you know what's really cool? You don't really say a lot of ums. And I'm like, really? I'm pretty sure I say a lot of ums around, because to find a word that's not very technical, you have to pause and think. You're like, okay, how would someone say this? It is. It's, yeah. Yeah. So, I don't know. I could tell probably now the rest of the episode, someone's going to be listening. They're going to be counting the ums, probably. So, don't say it.

Yeah, yeah, yeah. Um butts. Yeah. Yeah, you saw that. It was How I Met Your Mother, right? So, with then, if you have hip flexor pain, or sorry, let's just, gosh, it's hard to go down that route. Let's just say if you have a muscular pain in the hip area, in the front, I mean, what are the things that you like to do to address that? What's your success rate? Give me some feedback. Yeah. So, a lot of times with that, you know, I tell people all the time, you know, most endurance athletes, they want to hit their, and with endurance athletes, I think CrossFitters can be the same, but with endurance, we're so caught up into data.

We're so caught up into, you know, hitting our wattage, or nailing our splits, or split is how fast you're running, right? Now, I'm getting techy on you again. Oh, good. We're so caught up into the numbers, and especially if people are paying a coach to write their workouts, we're so caught up into, like, how to do the workout that your coach gave, and we don't, we think, almost to default into getting hurt. So, I think a lot of times I'll tell people, why don't you try, like, a 10 or a 15-minute yoga flow, yoga flow, and I think we know yoga flow is just the basic, kind of just, you know, maybe 10 different poses, kind of slow, methodical, but a lot of times I'll tell people, try, like, a yoga flow two or three times a week, and with, in, amongst our treatment plan here, and see what you get out of that, and you tell me, Seb, do you ever prescribe yoga to people?

I don't necessarily say yoga, per se, and the reason is because I don't, I don't want them to go out and, like, find any generic yoga that might be subpar. I think yoga can be great, but unless I know the skill of the person providing it, I hate to give generalizations. Okay. I give them, I give them recommendations here of some things they can do, but yeah. Sure. Shit, I was saying um again. So, I guess you're right. Usually, I show them, I say, here's five poses, and I show them, like, just do it slow, kind of almost putting yourself to sleep. Like, here's five poses, go through each pose five times, take ten minutes to do the whole thing, and do this three times a week. So, you're right. I kind of give that to them as well. Yeah. But that's what I give them as their homework. Yeah, I totally agree. I mean, I think definitely having them do stuff that is, like, catered specific to what, you know, you want them to do, I think, is a little bit better than just saying, like, hey, won't you try? I heard P90X works. Go try that, you know? It's... Yeah. Yeah. And with endurance people, a lot of times, again, we're so data, we think, oh, well, hell, if I'm going to go do yoga, it better be intense. I better be killing myself. And, you know, I better burn X calories, and I better hit my wattage. And that, it's... Nah, it's too many times we don't... I think we don't slow down and kind of, you know, pay attention to what really hurts or we don't think about it. We just kind of go through it. Because endurance sports are pretty robotic, right? It's run up this hill, ride your bike from point A to point B. Yeah. I don't know if you... Did you... I don't know if you heard the other podcast I did with... His name was Tim Fleischer. Did you... It was... He's a triathlete plus a Pilates guy. Oh, yeah. But... So, he had the same... He had the same thing. He's actually... Or he's actually... He does active release, too. I met him in Kona. And he's an anatomist. He's got a very well-rounded with a bunch of stuff to share. But... So, I asked him some of the same triathlete stuff. And he said the same thing. He's like, they just need to learn how to chill a little bit.

It just... Well, he was talking about zones at the time. So, he was getting a little bit techy, too. Yeah. So, yeah. He said, bring it down a couple of zones. That's funny. Well, so, when you were saying that their coach is asking them to do X, Y, and Z at this intensity, is part of the treatment or remedy to this thing? Is it modification based upon what their body can tolerate? Or is it just treat the hell out of it? Say that one more time. So, it sounded like you were saying that when they have, like, online programming or their coach is asking them to do a certain thing or a certain workout at certain intensity. So, it sounds like that you were saying that part of their treatment or correction to the hip flexor condition, or whatever it might be, was to modify that, not just to hit the data.

Yes, correct. Yeah. Part of that, yeah. Part of it is to modify that. We had a guy in here the other day that with an anterior hip flexor problem, and he thinks he did it by, you know, he's a triathlon guy, and he was deadlifting and just throwing his hips or thrusting his hips forward, which how many triathletes do any deadlifting, first of all? Yeah. I think that's cool that he is, but his technique is probably shitty because he's a triathlete. We don't do that stuff, right? Yeah. We're a bunch of skinny people. So... How much was he deadlifting? Was it a lot? Yeah, I don't know. Probably 35 pounds. Yeah. Yeah. But yeah, so we talked about we got to just lay off that exercise for at least a week, and then we'll go back to it and retest it. But we talked about, again, I talked about some corrective exercises in here, which some of them are just basic yoga poses. And then we talked about having easy spin on the bike just to kind of keep some mobility going, but not stressing the system too much. So then I wonder, do you have videos of you doing yoga? Because I really want to see this. You know, there's a million yoga videos up. Maybe that would be the one that would go over it, right? That might be more successful than Bitcoin. I'll try that, yeah. Yeah, I might. So then do you ever program in Rest? Because it sounds like you're just toning them down a little bit. Yeah, yeah. We just tone it down a little bit. I show them a couple stretches. We go over it. In the office, we've got a rig set up with some elastic bands. And we go through a couple things like that. But yeah, I just put them on a basic program. And I think you and I on this one. But people, unless it's, you know, like a labral tear or an FAI, or unless it's like a surgical problem, people, they should be getting better within a couple weeks. It shouldn't be, you know, this should not be an end of season type thing. Yeah, I agree. I think anytime someone's not improving at the expected rate, then I consider number one, was I wrong? Number two, are they doing something hidden to where it's not allowing the sensitive or damaged region to heal? I remember I had a girl one time that she had, she had like plantar fasciitis or something like that. So she was a runner. I think she was running, she was around 80 miles a week. That's a lot of miles. Yeah. So she had a, she actually, I had to refer her out and she had an injectable done. She had, I think, PRP or STEM, I forget what at the time. So her instructions were to not, not do any mileage. So she jumped on the bike and did about a, I forget, it was, it was a shit ton of mileage on the bike. So when I finally asked, you know, like, well, how are you feeling? She's like, not very good. What'd you do this week? Well, I did a shit ton of miles on the bike. You know, and like, well, can't, we said, let's keep that down or you can, you can swim or something like that. But it just wasn't, it was a miscommunication. Okay. So, but that's, that's another reason why I consider that maybe they, maybe they're doing something they're not telling me, you know? Yeah. So that's a good, that's a good point. That's a good point.

But maybe they're, well, and I feel like that's a good point. A lot of times, especially with endurance athletes, cause they're in the mind frames, they gotta, gotta do something every day. So maybe they're like playing flag football with their buddies or, you know, or skate skiing or, you know, doing some other stuff that they don't, they don't consider a workout, but really or playing like on your buddy's, uh, beer, softball beer league. That's, I know that's what you, you're big into that, right? The beer leagues for softball? Not the beer league anymore. Actually, I, I vetoed doing, uh, softball because I, I don't think it was skill. It was enough skill. I, I, so I, I, I'm, I'm, I'm, I'm in baseball right now. Well, I thought, wait, I thought every baseball guy retired and just, you know, put on a, got a huge, a huge gut and then just went into softball.

I think, I think you're, you're thinking correctly on that. However, I gotta say that for every baseball player that didn't take care of their body, nor does the work during the week to play baseball, plays softball. Oh, okay. That's the difference. Or, or here's what they're going to say. Well, hey man, once you play, I'll ask him, hey, once you play baseball, they're like, oh, it's just, it's just so long, right? Because softball is an hour. And, and I'm like, you play, you play a tournament a weekend. It takes an entire day. What are you talking about? It takes too long. That's a good point. That's a good point. And in baseball, you probably don't, there's probably not a cooler at second base, right? No, there's not. And I mean, I actually, I stood in one time as a, I did, I did a tournament and it was called a big league, big league dreams. So we had a game at 10 a.m. I want to say at one, at three, and then again at 10 p.m. So I got stuck in the outfield because I'm one that can still run. And the problem with softball is that no one misses the ball. Like no one does not hit it. And they all go to the outfield. I couldn't walk for a week.

It was just so much sprinting. Baseball, baseball, you get a lot more. It's like if you got like five balls in the outfield, you had to sprint two and did a triple. That's a lot of running, you know? Yeah. That's a good point though. In softball, everybody, I mean, in softball, if you can't hit it, yeah, you're not, yeah, you're playing, you're playing catcher or you're in the sidelines. Yeah. We, we actually had on that team, um, they, there was a couple of guys I played baseball with in high school. And so we put in, I think 20 bucks for the person that had the highest batting average to the end of the end of the tournament. So at the end of it, I think my batting average was close to 600, which was, which, which was really poor because our, the top three people had batting averages of close to like, uh, 900. You just do not miss the ball.

That's funny, man. Yeah. Oh, geez. You don't have, you don't have a softball like that out in Utah or just, I know they're not probably crushing beers cause you can't get them on Sundays, huh? You got to show up on Saturday night to be prepared. Yeah. Yeah. Right. Well, first of all, no one plays on Sunday anyway. Oh, that does make sense. That's why you get your, that's why you get your beers on Saturday. Yeah. Hey, but that is the best time, the best time to be on a long bike ride is Sunday morning out here. Is it? Absolutely. It's cause no one, no one's, no one goes to leisure, right? Like no one goes up the mountain. Nope. You're right. You're absolutely right. That was the best, that was the best time, the best time of the whole week by far. Nice. You just ride right in the middle of the highway. Yeah. Maybe in aero. Yeah. In aero. Okay. Here's a random question. I don't, I don't know if there's any relevance in this, but do you usually see people with right or left, right or left hip pain in dominance? Yeah, that's a good, that's a good question. I mean, I was just thinking about the past three days here at work. Uh, gosh. Um, right, right. I think two right-handed guys, the guy lift, the guy doing the power clean. I don't know if that counts, but, uh, two other runners, they're right-handed people and it was on their right side of their hip. Um, I don't know. There might be some that, and I, when we talk about that, the same, you know, that their dominant leg, does that leg spend more time on the ground? Does that leg hit the ground harder? Does that leg, you know, have more push off? There's a lot of things that go into that. And then there's other factors, you know, do they sleep on that side at night? Do they cross that leg over the other for eight hours a day at work? I mean, there's so many variables in that discussion. Yeah. Well, I just didn't know if he had an observation of it. I, after said it, I couldn't, I couldn't think of a dominance of shoulders or hips or anything like that. Yeah. Yeah. There, there was, I think I found a dominance with disc injuries though, or radiculopathies. So, right-sided leg pain because of left lateral flexion and flexion. So, when people stick their ass into a car and they just plop in, they still have their body hanging out, but their ass leads. Yeah. So, yeah. So, I've been trying to figure out how to get people to not do that. So, I have them pull themselves into the car. I actually made a YouTube video on it. Can't you just get in on the passenger side? Yeah, you could and crawl across, like, I don't know. You got a semi-truck over there or something? Yeah. You know, you might have something there though. I mean, there's a lot of people that like, what about a UPS driver? What about an Uber guy? If the guy's nice and he gets out of the car every time, I mean, he's poking his butt into the corner, you know?

He's putting his ass into that seat a lot of times during the day. Yeah. Yeah, I think people will have a dominance of something usually, but I know on bikes, like, you get the power meter, right? Uh-huh. So, you don't find anything. Gosh, I don't know if you hear that. I got a phone call coming on the other side. It's my dad. Hopefully, he doesn't. Go ahead. I think we're cycling. Hey, say hi for me, huh? I'm not going to answer. I just don't know how to stop it without stopping your call. Hello, Mr. Gonzales. Did he tell you to clean up your room? No, not this week. Yeah. No, I think you're right. A lot of times with, and I'm sure you see this, but even with bikers, they'll say, you know, it's always my left side. It's my left knee or my left hip or my left calf muscle or my left lower back. How come it's always on my left, always on my left? You know, and I'm curious. It's got to be the mechanics the way people are, but, you know, riding a bike, if we're going to, you know, sprint ahead of somebody or stopped at a red light and we're going to, like, push our foot down to get some momentum or, you know, if we're really going to dig on the pedals or kind of hammer on the pedals, a lot of times we're going to push down with the left or the right leg, our stronger leg. We just shove that pedal down first just to kind of get this momentum going. And I think a lot of times that is the leg that gets sore, that gets hurt more because, you know, and I've got a good friend that does bicycle fitting and he's very, very good at it. And he has all sorts of, they can measure the power between the left and the right side. And, you know, I think it's a lot of times the powerful side is the side that's more sore on a bike.

And it may be that way on the run too. There's really not a really easy way to quantify power left versus right side when we're running. There's some like gadgets and gizmos, but I don't think there's anything really as really super significant yet. But I find the more powerful side on a bicycle is generally the more sore or the more injury prone side. Yeah. I wonder, or I don't know if you've never taken a spin class, right? Never. Let's see, today's Friday, right? So that means I went Monday, Wednesday. That means tomorrow morning, I'll call you at 530 on my way there. To your spin class? Yep.

I can't wait. True story, actually. I went to one a couple times and it was okay, actually. But I looked over and there was this lady who, I mean, she was definitely more out of shape than I was and had all those little metrics on the top and she was dominating me and she was barely working. I'm like, how's this lady manipulating the system right now? That's totally not fair. But here's the thing I see with them is that like with, it seemed like someone, it's like a coordinated dance thing where it's like your right leg drives down and you're like down, down, down, right? And so like you're creating a dominant side, aren't you? That's a good point. Well, and again, like I said earlier, sometimes we get caught up like on my right side, I push down hard and my left side might pull up. So pulling up on the bike's pedal is a hamstring, pushing down is quad. But sometimes we get a lot better push on one side, pull on the other. To be exactly symmetrical, it's, I mean, a lot of times on the bike saddle, me included, I feel like I'm like my butt is sliding off to the left side. And my butt may be sliding off to the left of the saddle, but it's probably because of a dominant muscle thing or a push and pull harder on the pedal. Yeah. Well, can't you do like a, just unclip on one side and just like spend 20 minutes just single side pedaling?

Yeah. Funny you say that. We do that all the time. And it's like, so we do like a two minute interval. It's just one leg. Yeah. And it's supposed to make that weak leg stronger, but I don't know. I just think it hurts to sit on the saddle when you're pedaling with one leg. Yeah. Maybe you can create some type of device where you can still have your foot on the pedal. You just don't have any ability to push into it or pulling it. Yeah. I can imagine there's a whole group of 20 people riding up Utah Canyon on a Sunday morning, just single side pushing. You know, we had a guy, we had a guy, I've been doing the same indoor winter spinning program. I think this is my seventh year doing it with the same group of guys. It's a great group. Everything's data plugged in. It's as geeked out as you can get, but it makes an average guy a strong biker. We had a guy a couple of years ago. He was an amputee from the knee down, so he still has quad strength, but of course, you still use your foot and your Achilles and your calf. He was an amputee from the knee down, and he crushed everybody. His average power. Sometimes a disability, sometimes what appears to be a disability is a huge advantage.

Yeah. I can definitely vouch for that, too. I have a friend who is part of the Paralympic team, and he's a cyclist. One day, we went out and we went for a 30-mile ride or something like that, and he brought a couple of his friends who also were disabled, too. They just dominated me. There's a hill over here, and it's not even that long, but they were having this regular conversation on the way up, and I see them starting slowly getting further and further away. By the time we hit the top of the hill, they were a good probably 200 yards out, and they had to wait for me, but they all had some type of ailment. One one guy, he couldn't use a leg at all, and he was still crushing me. Yeah, those Paralympians, that's as tough as they get. Yeah, they're hard. They got true grit, huh?

That's down in Chula Vista, right? Yeah, they have a training center down there, but some of them go out to, like this guy went out to Colorado, the Springs, and they just invite him out, I think. Yeah, yeah, yeah. Huh, that's great. So what else you got going on over there? What are you excited about with triathletes right now, besides getting free airfare and going around and winning age groups? Free airfare, yeah. It's kind of funny around here. In the summer, everybody's outside on the bike. Biker, endurance athletes, there's no off-season. I mean, there is, but there isn't. Right now, it's called a power-based indoor cycling. It's three to four times a week. It's on a trainer, which means you ride the bike stationary. You're not going anywhere, which sounds weird to ride a bicycle in a dark room and you're not going anywhere. Well, especially on your trainer name, Bob. Yeah, right. And that is the other weird thing. A lot of triathletes, a lot of bikers and triathletes, they have a name for their bike. I've never named a bicycle. Have you ever done it? Do you have a name for your baseball mitt, Seb? Have you got a name for your cleats or anything? No, no. I do take a lot of pride in my bat, but that's only when it's new. After it's been used, I don't even bring it in the room anymore. So the bat sleeps in the garage or something? Yeah, it's in the garage, but like, you know, when you first get a bat, especially like a wood bat, you got to tape it up and stuff. So I'd rather be upstairs. I'm taping it. And then I bring it in the bedroom.

I'm just kind of like touching. It's so smooth. It's so clean still, you know? And then eventually when I take it out there, it's like it gets all scuffed up and dirt and everything. I'll sleep it in the garage now. That's a good point. Lucille. Lucille. So you do have a name for things. That's so funny. No name. So go ahead. Go ahead. You're talking about the trainers. Yeah. So right now we ride the bike, ride the bike three times a week, three to four times a week. It's usually an hour and a half on Monday. And for me particularly, hour and a half on Monday, Wednesday morning at 5.30 a.m. Pretty killer, right? Yeah. Before you go to work. Yeah. Yeah. And then on Saturday or Sunday, it's usually, you know, a two to a three hour effort depending on what's going on. But so, but really ride it.

Riding the bike indoors, and most endurance people know this, gosh, it makes you so much stronger for when it gets warm and you go outdoors. So that's a huge advantage we have on Californians is we have the four seasons here, so we have to go inside and we're going to get a lot stronger riding the bike indoors. We can go inside too. Yeah. Yeah. But we don't. Yeah. It's better than the ride. I guess you go ride the bike in the sand. Yeah. I don't think it'd work. Those tires are way too skinny. No, but it always makes me, we've been doing that for about a month out here, riding indoors. And funny enough, it puts you around your teammates and around your buddies. And sometimes you're riding outside and people get spread out, obviously. So I'm excited about, I still stay excited about riding the bike indoors. You get to build better relationships. For me as a clinician, for me as a clinician, you get to see people, you get to talk about whether their pedal stroke is jacked up, whether, you know, we're going to talk about everything on a clinical basis, whether their hip hurts or whether they're getting headaches because their handlebars are screwy or whatever that is. Sometimes that's harder to do outside. But we can talk about a lot more of that when everybody's riding the bike like three feet away from each other and you're, and oh, by the way, you're stuck there for an hour and a half.

You can always jump off the bike and say, all right, I'll come back in when this conversation's over. Yeah, exactly. Well, so then, so then if someone like say they're, you know, their stems a little bit like messed up and so on and they got neck pain, do other people say, oh, yeah, I got the same thing? Like, is it like kind of like, you know, when girls are living with each other, all their periods match? It's an epidemic, right? Yeah, that's a, that's, you're starting the epidemic in the wintertime. That's a good point. You know, I, and I, um, if there's one thing I've learned in the past 11 years, um, is that you learn to be good at what you're good at and pass on what you're not. So I refer him to a guy we know that does bike fitting and he's good at that stuff, but I'm not telling anybody their handlebars are too high or too low and that causes their problem. I can help them with headaches, but I'm not going to tell them to change their bike fit because that is not what I do. Yeah. But I have a great, but I know a guy who's really good at it. I would imagine that, I mean, I, I have a, I have a rule. I usually don't work with, uh, people's kids. Um, especially under a certain age, just because they're very protective of their kids. And if you mess up, then they're going to be really upset.

And I would imagine these people naming their bikes. If you mess with their fitting, they might lose their mind, won't they? That's a good point. And people are so, one of my friends I train with all the time, I think he changes the seat post or the height, the height of his seat. I think he changes it about every two weeks. Really? He's awesome. You know, I got something that's like, well, maybe if you would have left it two weeks ago, it'd be just fine right now. I thought it was more like a mystery day. It's like, hey, you want me to mess with your seat today? Yeah, sure. Do it. Surprise me. Wouldn't that be fun, right? But I do feel like now, from a clinical perspective, riding the bike, and for any endurance people that care to pay attention, I do think riding the bike indoors a lot, you know, there are some bikers, and especially triathlon people, that ride their bike, let's say, 80%, maybe 90% indoors, and they almost never go outside. And that could be for traffic, or that could be from economical time, time management. But I do think, you know, little injuries, little injuries, like a little hip pain, like a little knee, kind of a little bit of a knee pain type, those things can get exacerbated by riding the bike indoors all the time.

Mainly, mainly because when we're indoors, we're kind of locked in place, we're kind of sort of cemented in place. When we're outside, you know, we kind of move our butt around, we kind of go up and down, we're climbing a hill, we're just there's more variety, if that makes sense. There's more variety for our body. Whereas when we're inside, it's, you know, we can sit up and sit down, but we don't, we don't ever turn. We don't ever climb a hill. We don't ever, you know, do a 90 degree U-turn to get around a streetlight or we don't ever have to dodge any, like dogs or anything. So I do think there is something to be said about still getting outdoor on the bike and just it helps with the hip problem or the knee problem just to get outside.

Yeah, this is probably why Californians have less hip pain on a bike is because we're outdoors more. I think you might be on to another thing there. Yeah. You know, I was thinking about this before that fitting yourself to a bike or getting bike fitted, I think is obviously really important. But at the same time, it's like, who does I feel like fitting yourself onto an object, which is not part of your body and expecting it to not hurt, I think is pretty ridiculous. Like I feel like it's kind of supposed to hurt. You're being fixed to in a bike. Like running, I don't feel like running should really hurt. Swimming shouldn't hurt. But biking, I feel like inherently there's something that will like it just geometry doesn't work for us, you know? I don't know. There's a lot more. All right, bring on your bike fitting friend. Let's talk about this. That's right. Oh, man. He would talk to you all for a week. Well, I still don't know the answer to it. But I don't know. I'm about to do a video on there's a whole gonna be a whole month on ADLs like how to get out of bed pain free how to put on a jacket with a shoulder condition. And one's gonna be how to ride a beach cruiser without having back pain. Beach cruiser, you just put your butt down there and you just cruise. What are you talking about? I don't know. It seems like it. I don't know. I see people around here like with the obviously they don't all have, you know, thousand dollar bikes and stuff. They have these. Wait, wait, wait. How much does a beach cruiser cost? A beach cruiser? You want. So mine actually have a general rule with cruisers is I don't buy anything under over $100 because I know it can possibly get stolen and I don't want to care about it because it'd be true. Okay, okay. So I get the stupid huffy one from like Walmart or Target and, you know, max, I think I spent 120 last time. And, but you see people with these cruisers because they're everywhere and their seat is like super low so their knees are like way high. They can't get full knee extension when they're full. Like, this is a real thing, man. Like, this is how people ride down here. Yeah. You guys are serious about it out there. No one has beach cruises out there, right? No, no, no. Just hybrids and mountain bikes? You gotta invite some of those beach cruiser guys down to Oceanside Pier. I think it's April 1st this year is the Ironman race down there. Yeah. Yeah, they might make it. You ever been passed by someone on a fixed gear bike? I'll tell you what, some of those fixed gear guys are the toughest guys out there, though. Yeah. Some of them. They're deceptively tough. Yeah. I remember being passed by one with a MRSE and no helmet, and he was just crushing me. Yeah. He was probably like a legit biker. That was his recovery spin or something like that. You caught him on the wrong time. You're probably right. And you gave him that look.

You gave him that look that you give to somebody when they're about to throw you a fastball. When you're about to deliver the fastball, when you're about to throw them something nasty. Oh, yeah. Yeah. That's... Oh, you're supposed to point at them and then shake your finger? Mm-mm. Mm-mm. Oh, geez. No. Actually, it's funny. There is a real thing. I don't know if this just happens with the outfielders that I have been around. But when someone tries to run on you from the outfield, it's like offensive. It's like, how dare you? And when you throw them out, it's like, that's right. You don't disrespect. Yeah. It's better than getting a base hit or a stolen base or anything because you only get once every couple, every two to four games probably. Hmm. So you're saying you're playing center field, a guy tags up at second base and he's trying to get to third and you throw him out at third. Oh, yeah.

That's like the most exciting thing in the world. But the worst is when the third baseman drops it. Yeah, right. And then you walk, you go into the dugout and you ask the other players like, hey, so was he going to be out? You know? Yeah, right. You want to make sure that you did your part. So taking that into triathlon, that's, that's, you get into T2. Okay. Okay. Right. Yeah. Yeah. Transition two. Exactly. You get in transition two, you realize you're, you're ahead of the, that guy in your age group that you're just tired of losing to him or he's just a punk or he's from a rival, he's from a rival group. You get into T2 right ahead of that guy. You got like a minute on him or let's say five minutes on the guy. You get into T2 and your shoes untied or you're running, you're running shoes untied or, or, or like your rate, your race bib or you can't find your glasses or, or like you trip. And before long, you get out of transition two to start running and he's right on your heels. So that infuriates you. Oh, well then, or what's even worse is that you get to like, there's one mile left on the run and the guy passes you. You've been winning 90% of the, it's like giving up a, it's like giving up a homer in extra innings, right? Yeah. Yeah. Well, he's been pacing you for a while, right? Yeah. He's, yeah. He's been stalking for a while. Yeah. Yeah. I mean, there, there has to be like when you're, when you're racing, you, you eyeball someone about like, you know, 20, 30 yards away and you just hang on to them for like 10 miles and then you just finally get them right. That's called drafting baby. Yeah. That's, you were, when they pass you, you're like their poster boy in basketball. Yeah, exactly. I'd much rather, much rather be in second place in the past than be in first place and trying to hold off the second place guy. I would, I would too. I think it's, I'd rather, I'd rather finish strong than finish weak. Yeah. No. So, so let's go, let's go back on hip real quick here because I know we're going to, we're going to come to the end of this podcast real fast and we've been messing around talking about. So what corrective exercises do you like? Like generally speaking, you have to get, you don't have to get anything super specific. Right. Into your hip stuff. Uh, let's say like someone comes in with like, what are probably the top five things like someone, so a triathlete that comes in or a biker that has low back hip, uh, quad something or other. Okay.

Well, especially in the sport of cycling, running and or triathlon, those sports are very linear and they're very frontal plane. In other words, moving forwards, maybe a little bit backwards, but all the motions, if we think about it, are very forwards. So in those sports, we rarely do any lateral movement or side to side movement. So a lot of corrective stuff I like to give is, you know, like some instability stuff like a BOSU ball or, um, like an elastic band around the knees or the ankles and some side to side walking like a monster walk. Um, I like to get them almost, almost like doing, almost like doing walk, like a, like then that's where yoga comes in because it bends and twists and all different planes of motion rather than forwards. Um, does that make sense? Yeah. So, so often, how often are they supposed to do something like that? And like, uh, how, like when do they do it? Yeah. Um, you know, and, and every, that's a, that's a good question. I guess everybody's different. That depends on your diagnostic skills. That depends on, you know, how long it's been hurting, how bad it's been hurting.

Do they wake up with pain? Does it only hurt when they're on the bike? Um, you know, things like that. But I generally, I like to have people doing corrective exercises, uh, really daily. Is it, do you ever get any resistance to it? The frequency anyways? It depends on the person. If it's, if it's a real, it says, if it's a pretty hardcore biker or a pretty hardcore cyclist, hardcore biker, hardcore triathlon, if anything, you can't give them enough stuff to do because they're very kind of a type A type of a, you know, you tell me that you tell them to work out for an hour, they'll work out for an hour and a half.

Huh? That type of mentality. So, but if it's more of a casual, let's say our casual guy that has hip pain while he's just sitting at his desk all day, he's not really athletic. Maybe he plays basketball once a week, that type guy, that guy, you tell him to work out three times a week or do corrective exercise every day. If we tell him to do corrective exercise every day, we're lucky to get three times a week. Yeah. So then the way you say it to the type A versus that other dude, do you say like, hey, I want this no more than 10 minutes a day versus, hey, do this 30 minutes every day? That's a good question. That's a good question. Yeah. I'll tell him like, you know, yeah, I'll tell him this is like 10 to 15 minutes a day. That way it doesn't cut into some of their other workouts they're already trying to nail.

Yeah. You know, I did have a conversation with the Tim Fleischer, like I mentioned earlier, and we were talking about should, do you feel like doing this rotational or frontal plane stuff, these extra activities, should it take a precedence over mileage at any point? Is there, do they need to take away from their mileage? And that's a good point. I think that gets into the quality versus quantity discussion. You know what I mean? There's a, going back, the guy, Craig Alexander, the guy who, he won, let's see, did he win three times in a row? He won three times in a row in Kona and four times overall, if I remember right. He wrote, he wrote a book about, he won twice.

He, he won in Kona twice, which Ironman Hawaii is the Super Bowl for triathlon. Of course, you know that. I think he won twice out there. And then his third, he was going for the three Pete and he just got his ass whipped out there on his three Pete. Yeah. When he, he was, he was everybody's prediction to win. And in his book, he talks about, he'd never done any strength training, any like any, uh, different planes of motion work, never done any like dumbbells, any work on a ball, any, you know, just, uh, wood chops or any elastic band work or any, and that, and then the next off season, that's what he did is he put all those different planes and strength training things in there. And then he went back the very next year. And I think he had a, I think he, he broke the record on the bikes on the bike portion of the race. Oh yeah. So did then he, did he just add or did he take away? Like, cause I know people only have a certain amount of hours in the day. Exactly. Yeah, exactly. He hired, he hired a trainer, uh, you know, sport, a sport specific trainer. And I think he did, he took away a little bit, but you're right for the, for the average guy out there, there's only so many hours in a day. So he took away, he took away some of the mileage, but I think when it came down to his running, he just did a little more quality versus, you know, we call them, um, garbage miles or junk miles.

Yeah. He took away some of the junk miles. Yeah. Just doing it to do it. Low, low quality effort, maybe. Yeah. Yeah. I, um, I have a friend actually, he's, uh, I don't think you might've met him. Uh, is it Richard Hanson? He's in college. He's in Boulder. Hmm. I feel like you met him. Oh, Richie. Yeah. Richie. Oh yeah. Yeah. You know, Richie. Um, yeah, yeah, yeah. I follow him. He's a good Twitter follow. You really, I hate Twitter. I would, or I would follow. I mean, I think I follow him, but I don't understand. He even, I even had a look at a Twitter feed. It's too many links, man. Yeah. Well, I don't understand half the stuff he puts out, but the stuff I, I always read his stuff and his splits and whatnot makes sense to me. But yeah, Richie's a good guy. Yeah. He, he was telling me that there was, uh, so with his, uh, Rich running project, it was the professional team that he's coaching. He's, he's actually the only person I've ever met that actually coaches the team as well as just the clinician for him. And so I think he was telling me, I guess I'd have to have him on to, to confirm this, but so he, he started using a heart rate variability to cut down basically, uh, low quality efforts.

And so he was having really good success with doing less mileage over the year versus, uh, or according to what the recovery was versus just doing a standard, like almost like a linear approach or, or just setting a rough mileage and having garbage miles, you know? Yeah. Interesting. Yeah. That's interesting. I mean, he, he would be the guy you're going to have to get him on sometime. I've been trying a little asshole. Like he, like I, I, I shared a room with him. Like, uh, uh, it was last year or a year and a half ago. I was like, he did a great presentation at the sports chiropractic symposium and he had an awesome chart, which I've been trying to get from him, which was, uh, it was something to the effect of when you have an injury for the amount of days that you take off, what's your injury risk as you come back? Yeah, it was great. And, uh, but I was like, dude, we should just do a podcast on this stuff, but he's, he just got married. So he's a little bit busy, I think, but, uh, we've been trying to hook up on it. I thought he had a girlfriend forever.

Uh, they were, I mean, they were dating for at least, I think three, four years, but they're married now. Same thing as being married. It's not any busier. No. Yeah. Unless his mother-in-law lives in his basement now. I don't know. Uh, yeah, I think, I think half the time, sometimes the mother-in-law comes with the bride, right? Oh, man. Yeah. He'd be a good one. I know he was in our fantasy league, huh? Oh, yeah, yeah, yeah. That's right. That's right. Yeah. And he uses, if I remember, he did all right. So that means he's spending too much time on fantasy. He spent way too much time on fantasy.

That's the thing. If you do good in fantasy football, that usually means you're the biggest loser. Yeah, you're right. Hey, I did, I did place top three. You're right. Oh, you only say that because you're always last. We had to boot you out because you wouldn't look at it. See, that's what I mean. I got too much other stuff going on. Yeah, right. I can totally vouch for it. I don't think that works. I don't know if that logic works because this year, that same league, I actually didn't even draft, nor did I. Actually, no, I think it was last year. So we weren't able to really draft, and I think I got third. And I didn't even look at my team all year. Yeah. Auto draft, baby. That's right. It's always luck of the draw.

That's funny. Go ahead. I think quality versus quantity, it's tough, though. I think mentally that's tough because it's the same as baseball, maybe. You get used to going out to the ballpark every Tuesday night, or we get used to, I mean, weightlifters, they get used to every Wednesday is chest, and every Thursday is back, and legs are Friday morning. With endurance sports, for me, I have done my long run on Saturday or Sunday morning for probably five or six years in a row now. Almost every Saturday or Sunday, if I'm in town, is a long run with my four or five good buddies, and to think, gosh, maybe I don't need to do a long run.

Maybe I don't need to run 15 or 10 this week. Maybe I need to work on some corrective exercises so I can run 10 miles in three years from now. I mean, we get so ingrained into these habits, I think, that sometimes thinking outside the box is, you know, it's hard to do. Yeah, no, I agree. I think that's one of the biggest, I don't want to say problems, but like the, like, I found that, like, the runners that I work with, a lot of times they want to really, they're concerned really about their long runs on Saturday. And I'm like, why? And they're like, well, because my friends are there. So it's not really about the mileage anymore, right?

Yeah, that's good. Well, and if they're good friends, the miles are just ticking away, right? Yeah, I said, you can just, you can just have breakfast afterwards or have coffee. Like, it's only going to take them. Like, I mean, how far are they going? You know, 10 miles? It won't take that long. Just sleep in and go show up to coffee. Yeah, yeah. That's why we start and end at a coffee shop. That's right. The coffee shops always get you. So how can everyone reach you as we close up here? Oh, yeah. Well, easy, easy to reach out here in Utah. It's Dr. Tom Fletcher. Yeah, I guess everybody has the Instagram thing now. The Instagram, the Facebook thing. My clinic is called Wasatch, which I love because everyone outside of Utah, they hear that every time we're talking to an insurance company or like anyone outside of Utah, they hear Wasatch and they're like, Wasackie? Wasatch is a mountain range out here in Utah, the Wasatch Mountain Range.

Yeah. It's Wasatch Health Solutions. Easy. You can find that anywhere. Online, Instagram, whatever. Facebook, Wasatch Health Solutions. Funny, actually, when I introduced you, I was thinking about cutting it out, but I just left it. So I was given your website and I did the same time. I'm like, what's it? Well, shit, I'll just spell it. I couldn't say it either. Well, how would you say El Segundo, right? El Segundi, El Segundo, you know, La Cagnada, La Candida, so I get it. Yeah. I don't know. I guess I don't see very many words with a W that end in H that aren't watch. All right. I guess you got me there. Yeah. Watch. I guess watch. Oh, shit. Yeah, that works. Wasatch, right? And this looks like watch with an S in it. All right. I just figured I can move to Utah now legally. Yeah, yeah, yeah. We'll take you. Yeah. Then again, I mean, half of Southern California is trying to move here right now anyway. Well, they're all going to St. George, aren't they? I think they're going to St.

George. Yeah, they're on their way, man. They're on their way. Yeah. I think it's tough. It's crowded down here. I really don't know how people that are getting out of school can't even afford a place to live, let alone own. It's expensive. Yeah. So, I don't know. It's got to be a dual income type of household here. Absolutely. Well, it's got to, yeah, word up, brother. Yeah. Oh, hey, I forgot to ask you. Did those posters come in? Yeah, man. Yeah, they're getting some good mileage already. Oh, good. Good. Off to get your... I'll have to get your input on it later. So, cool. Anything else you want to add before we close? Don't miss your long run. It's on your gravestone. Cool. All right. Well, thanks for coming on then. Yeah, as always. Yeah. Don't go anywhere. I'll come back after. Okay. Okay. I hope you liked that interview with Dr. Tom Fletcher from Murray, Utah. If you're looking for someone out there, he's a good guy to see. So, I would trust my parents going there. If you're looking for the show notes on this, I will go to p2sportscare.com slash podcast slash pound 82, which is the show number or the session number. If you're looking for all of those modern patient educational posters, go to the p2sportscare.com slash shop area and you'll find all that stuff there. Now, if you're looking to contact Tom, I will have all of his contact information in the show note area as well.

Remember, you can reach him at, I will just spell out because apparently I can't say the mountain range in Utah. It's w-a-s-a-t-c-h-h-s.com. That's the mountain range hs.com and go see him there. I mean, I'm looking at his Google reviews right now. He's got 42 five-star reviews. Pretty good. Holy crap. 66 on a different platform. Wow, he's got some good stuff out there or he's got some good reviews. Anyways, go visit him. He's a cool guy. He'll treat you right. Lastly, remember, it's not what you take, it's what you leave. Make sure that you are leaving the lasting impression on the world. This podcast is hopefully mine. Check out all the YouTube videos. They're coming out every single day. Share them with your friends. Talk to you soon.